Omega-3 Long Chain Polyunsaturated Fatty Acid Supplementation for Prevention of Retinopathy of Prematurity in Pre-Term Low Birth Weight Infants: A Pilot Study.

Background and Aims: Retinopathy of prematurity (ROP) is a vasoproliferative disorder of the retina affecting preterm infants that potentially leads to blindness. Omega-3 long-chain polyunsaturated fatty acids (LCPUFA) have anti-inflammatory and antiangiogenic effects, thereby reducing pathological neovascularization and preventing the incidence of ROP. This study was done to evaluate the effect of available omega-3 LCPUFA supplementation for the prevention of ROP among Bangladeshi infants. Methods: This pilot study was conducted in the Neonatology Department of a tertiary care hospital in Bangladesh from November 2022 to March 2024 among preterm neonates < 34 weeks of gestation with birth weight < 1800 g. Initially, 76 preterm neonates were enrolled in this study. Among them, 71 preterm neonates were randomly allocated to the intervention group and the control group. The intervention group received a cap. omega-3 LCPUFA enterally (40 mg/kg/day). It was added to their enteral feeds within 48 h of the first enteral feed and continued from the starting point to 4 weeks. The control group received no supplementation. Results: The incidence of ROP was almost similar between the omega-3 LCPUFA group and the control group (37.1% in the intervention group vs. 41.6% in the control group, p = 0.69). However, severe ROP incidence was significantly reduced in the omega-3 group. Three patients developed severe ROP in the omega-3 LCPUFA group, in contrast to nine patients in the control group (23.1% vs. 60%, p = 0.049). On logistic regression analysis, while considering risk factors for ROP, omega-3 LCPUFA supplementation was not found to have a significant association with the incidence of ROP. Conclusion: Omega-3 LCPUFA supplementation does not reduce the overall incidence of ROP; however, it may lower the risk of severe ROP. This reduction in severe ROP cases may help decrease the need for invasive treatments and improve long-term visual outcomes in preterm infants. Nonetheless, the study lacks sufficient statistical power to confirm this conclusively.